Case Report: Guillain-Barré Syndrome Secondary to Dengue Virus Infection in Northeast Mexico

Abstract

Aims: Dengue virus is a mosquito-born viral disease that infects about 390 million people each year. The clinical manifestations are fever, arthralgia and myalgia. Guillain-Barré Syndrome (GBS) caused by dengue fever has been rarely reported. Presentation of Case: A 46-year-old man with no relevant medical history was seen because of progressive quadriparesis, dysautonomia, dysphagia and facial paresia. Ten days before seeking medical care the patient had fever, myalgia, arthralgia, rash, thrombocytopenia, and a positive NS1 dengue antigen. GBS was suspected and immunoglobulin was started while nerve conduction studies confirmed an acute motor axonal polyradiculoneuropathy. According to Brighton criteria, the patient was classified with a level 2 diagnostic certainty, since it was decided to not perform lumbar puncture for CSF analysis. The patient had a good clinical response and was subsequently discharged. Discussion: Dengue virus is arthropod-borne. It presents with high fever, rash, arthralgia, myalgia, and in rare cases, neurological complications such as GBS. In Mexico, there were 14,112 confirmed cases of non-severe dengue and 3,683 cases of severe dengue or with warning signs in 2016. There are no reported cases of GBS secondary to dengue infection in this country. Conclusion: GBS following dengue fever should be considered in countries with a high incidence of dengue infection such as Mexico even if there are no previous manifestations of dengue fever.